Prospective randomized trial comparing stapled hemorrhoidopexy versus closed Ferguson hemorrhoidectomy

Area of Science:

• Colorectal Surgery
• Surgical Innovation
• Hemorrhoid Treatment

Background:

• Ferguson hemorrhoidectomy (FH) is associated with closed wounds, theorized to reduce postoperative pain.
• Stapled hemorrhoidopexy (SH) avoids a perianal wound, suggesting potentially lower pain levels.
• A prospective randomized trial was designed to compare SH and FH.

Purpose of the Study:

• To compare the efficacy and safety of stapled hemorrhoidopexy (SH) versus Ferguson hemorrhoidectomy (FH).
• To evaluate postoperative pain, operative time, hospital stay, morbidity, and complications between the two surgical techniques.

Main Methods:

• A prospective randomized trial involving 50 patients with third-degree or early fourth-degree hemorrhoids.
• Patients were randomized to undergo either FH or SH.
• Data collection included operative time, hospital stay, fecal incontinence, pain scores, morbidity, and complications.

Main Results:

• SH resulted in significantly less early postoperative pain compared to FH.
• No significant differences were observed in hospital stay or major complications between the groups.
• FH patients experienced more minor issues like bleeding, wound discharge, and pruritus; SH had one case requiring reintervention for thrombosed hemorrhoids and some patients reported lifestyle-affecting gas incontinence.

Conclusions:

• Stapled hemorrhoidopexy (SH) is a safe procedure associated with reduced postoperative pain and minor morbidity.
• Potential drawbacks of SH include the need for early reintervention and cases of gas incontinence impacting lifestyle.
• Ferguson hemorrhoidectomy (FH) is associated with more minor wound-related complications.